In this series of articles, Stress Illness: The Complete Guide, you’ll learn everything you need to know about Stress Illness/Psychophysiological Disorder/Mindbody Syndrome. Each article addresses a different aspect, the principles of recovery, physical symptoms, emotional aspects, the cognitive elements, the behaviours of those suffering, how worry is connected, the losses they face, and the remedies and therapies that are gaining research backing as effective treatment choices. The articles build into a useful reference for those wishing to understand more about the complexities of Chronic Pain and Stress Illnesses.
This article is the 8th of the series and will focus on the losses experienced due to Chronic Pain or Stress Illness.
Anxiety of Change
When we experience symptoms on a long-term basis, they start to affect all areas of our life; social life, relationships, work/education/volunteering, leisure pursuits. Sometimes these can be through necessity, sometimes through choice, but sometimes they can be forced on us by the situation or others.
All these changes can start to feel threatening. And as with any threat this causes additional anxiety. This anxiety causes several other effects.
Physically it can increase muscle tension, heart rate, and respiration rate. Which can exasperate current symptoms. Concentration, sleep, and internal bodily systems are often impacted too.
Our Immunity response, insulin production, and blood pressure can also be adversely altered. Further, anxiety may cause us to avoid certain events, places or people and thus reduce our social contacts further. Due to these symptoms all being obvious in life, we are very much aware of it. So, anxiety is one of the main emotions associated with chronic pain and stress illnesses. But it is by no means the only one.
Another emotion which has devastating effects on us when we suffer Stress Illness or Chronic Pain is grief.
The Grief of Chronic Pain
Grief is “an intense emotional experience triggered by a loss” (https://positivepsychology.com/grief-stages/ Accessed 24/07/2022). It is often associated with death but is a natural process designed to help with the trauma of any loss. As Chronic Pain and Stress Illnesses involve so many losses, including the past life, the limitations in current life, and those of the expected or hoped for future, sufferers experience substantially more grief than the general population. If the pain symptoms were initiated from trauma (either a one-off incident or a series of events) then grief for the losses incurred as a result will also require processing.
Losses of Chronic Pain
Here's a list of some of the loss that contributes to grief in people with Chronic Pain or Stress Illness. (You may notice that they mirror the principles of recovery discussed in a previous blog:
Loss - Clarity
Cause and Effect - Confusion
Searching for a diagnosis causes most sufferers upset, stress, worry, and confusion. Being unsure about what and why is going on in our bodies takes away the certainty we used to have. Confusion about symptoms daily. Never knowing what we can do and what we can’t, why some days are better than others, what is happening to your body and what to do about it, all create uncertainty and a sense of loss for what was previously known and understood.
Antidote - Curiosity and Grieving
Curiosity about Chronic Pain and Stress Illness recovery can help us to find the way forward. To create a new understanding and reduce the confusion.
Grieving these losses (see below)
Loss - Confidence
Cause and Effect - "I can't cope"
As we stop being able to do and achieve what was once possible physically (or fear that this may be so in the future) The thought “I can’t cope” becomes more common. We stop trusting in bodies.
As we struggle to remember things and words, experience reduced concentration and problem-solving abilities, we fear our minds decline. Lack of sleep leads to further issues with cognitive functioning. These all undermine our belief in our mind.
As time continues and we don’t experience signs of recovery (and maybe even increase in severity, duration, frequency, and array of symptoms) recovery starts to feel like another loss.
Antidote - Courage and Grieving
Courage to try out new things, to continue despite these fears and losses, are the hallmark of Stress Illness and Chronic Pain sufferers.
Retaining hope that recovery is possible, and that we will achieve it, is key to healing.
Grieving these losses (see below)
Loss - Control
Cause and Effect - Changeable
Lack of certainty about the future leads to a sense of losing control of life. The changeable nature of the bodily symptoms starts to feel frightening and disempowering.
As our lives become determined by what we can and can’t do, (rather than what we want and don’t want to do) we might start to battle with our symptoms, ignore them, or wish them away.
When we must depend on others for practical and emotional support, we lose the internal locus of control and grief and fear result.
Antidote - Choice and Grieving
Choice is always available. Deciding how and when and where our life goes is essential for human wellbeing. Although it feels that these choices are limited, recognising that we do still have choice can empower us again. The choice may be yes or no, to do the same or to do different. To not do anything or to do something. These simple choices enable us to take back some control of our mind, body, and life.
Grieving these losses (see below)
Loss - Connection
Cause and Effect - Compromise
Companionships struggle when at least one party has a chronic illness or condition if compromise cannot be reached. A lack of understanding, empathy, or consideration can cause relationships to fail. But not communicating the how we feel or what we need does not help make for a healthy compromise.
Breakdowns occur when we prevent ourselves asking for the help and support needed too. If we continue to struggle and refuse help, the people around us get frustrated and feel useless. This strains even the hardiest friendships.
We can also find it difficult to connect with ourselves. This may be a lifelong issue or due to the physical and emotional symptoms we experience.
Antidote - Communication and Grieving
Whichever, the lack of connection adds to our emotional baggage, loneliness, and loss.
Communication is key to recovering the social connection we lose.
We can work on our relationship with ourselves and learn ways to know and understand our needs better.
We can increase our skill in asking for what we need and want. We can learn to be more assertive, to create boundaries, and to be forgiving.
Grieving these losses (see below)
Loss - Consistency
Cause and Effect - Conflict
The nature of chronic pain leads to internal and external conflict. Internally, between what we used to do, and what we can do now. Between what we want and what we need. This leads to lack of consistency in how we show up in life.
Emotionally our mood can be up, then down. We can be angry in a flash. Anxious over nothing much at all. This is not only hard to live with but risks losing the trust and support of others.
The conflict between wanting to do everything when feeling okay, then feeling more unwell after, and unable to do anything, is called the boom/bust cycle. It can lead to loss of a job, an educational arrangement, volunteering opportunity, or other such things, that would normally increase meaning in life.
With a lack of consistency in our symptoms, it can lead to a loss of benefits in the UK.
Or loss of other opportunities and income if self-employed.
These can mean we face loss of income and the security that can offer.
Antidote - Compassion and Grieving
Compassion is the noticing of suffering, being moved to do something about it, and realising that suffering, imperfection, and failure are all integral to the human experience.
Compassion is not necessarily going to change situations, but it adapts how we view and interact with them. This means we are less likely to be adversely affected by the emotions created. Therefore, we can live with more ease.
Grieving these losses (see below)
You may recognise these. They are the 5 principles of Stress Illness and Chronic Pain recovery
Processing Grief
Processing of all emotions is tantamount to good health and wellbeing. If we do not process our emotions, they remain trapped in the body and risk causing chronic pain or stress illnesses (Van Der Kolk, 2014). Of all the emotions, grief holds a special place. It is the only one in the English language to have a name specifically for its processing.
There have been several models of grieving purported but the most common was suggested by Elizabeth Kübler-Ross (1969). She proposed that there were 5 stages, these are:
1. denial
2. anger
3. bargaining
4. depression
5. acceptance.
They do not necessary follow in order, and some may be experienced more intensely than others.
To address grief, it is helpful to know how to process emotions. Emotional Intelligence (Daniel Goleman, 1995) states that self-awareness and emotional regulation are key. The following process teaches how to start grieving SAFELY.
S.A.F.E.L.Y.
S – State the emotion. Naming an emotion enables us to move from an emotional stance to a more cognitive one thus enabling us to be more able to decide on the next action.
A – Allow the emotion. Trying to stifle or repress an emotion only causes it to stay in the body for later.
F – Feel the emotion in its fullness. Notice where it is in the body. Breathe into it.
E – Express the emotion. Write about it, draw it, talk about it. You don’t need to act it out.
L – Loosen the body. Take slow, deep, belly breaths. Walk, stretch.
Y – Your Welcome! Be grateful for the message the emotion conveyed.
Recovering From Chronic Pain and Stress Illnesses
If you are ready to start to address Chronic Pain or Stress Illness, then this 30-Day Workbook will help you. It’s packed full of value. There is an exercise to undertake everyday for a month. Support is offered in an online group, and emails are sent to keep you accountable. For more details…
Take Care
Tina x